Surgeon&#39;s tool



Oct. 17, 1944.

H. N. STEVENSON SURGEONS TOOL Filed May 25, 1943 INVENTOR fzaununfif'rzyrwozv 9 W ATTOR EYS Patented Oct. 17, 1944 UNITED STATES PATENT OFFICE SURGEONS' TOOL Holland N. Stevenson, New Rochelle, NY.

. Application May 25, 1943, Serial No. 488,343

4 Claims.

This invention relates to a surgeons tool. Its purpose is to help movebroken bones of the skull into position for healing and to hold them in place for healing.

It is particularly useful in cases where nose and jaw bones are broken. Some prior art tools for this purpose are shown in the publication Fractures of the Jaws by Ivy and Curtis, published in 1931 by Lea & Febiger.

My improved tool is shown in the drawing, in which.

Fig. 1 is a front and Fig. 2 is a side View of the tool mounted on a patients head;

Fig. 3 to Fig. 6 are detail views of tool parts; and

Fig. 7 is a side view of the tool arranged for a diiferent operation than in the case of Figs. 1 and 2.

The tool as shown in Figs. 1 and 2 indicates its position when used to set and hold a break in a palate bone. In this position the bone has been set and the broken edges are held together for healing by the traction wire, the ends of which show as l and 2. These ends are held in position by fastening them to the sides 34 of a hairpinshaped wire. These side wires are separately held as shown best in Fig. 6. Each has an adjustable mounting for holding it, and of the same character. One of these mountings will now be described. It consists of a frame piece having three legs 5, 6, l-see Fig. 4. Leg 6 is threaded and extends from the under side through slot 8 ofheadband 9. Legs and I extend forwardly, one adjacent the top and one adjacent the bottom of the band 9. A keeper piece I0, see Fig. 3, engages the three legs 5, 6, 1 by the two notches i l and hole 12. Legs 5 and I each have mounted on it a wire holder such as shown in Fig. 5. This consists of a block I3 with a square hole l4 through it to slide on its one of the square sectioned legs 5 or 1. Block 13 also has a slot l5 to pass a wire 3 or 4 loosely through it, and a finger screw IE to bind the wire in slot l5 when adjusted as desired and hold it firmly to post 5 or 1. Each block I3 is the same, one on leg 5 and one on leg 1. The threaded leg 6 has a finger nut I! to clamp keeper piece I!) in adjusted position on band 9. All the parts of the adjustable mounting described, except the screw threaded ones, are fitted one to the other with considerable play. That is, they are not closely but loosely fitted parts, and deliberately loose for a purpose to be stated later. Assuming that the adjustable mounting just described is for holding the wire will want to anchor wire ends I and 2.

3; the second adjustable mounting, to the right in Fig. 1, is of the same construction for holding wire 4.

The band 9 may be held on the head by a fitted strap. As it is the fixed anchor from which the wire 34 is to be adjusted, its fixed relation to the head is important. A plaster cast, indicated by dotted line l8, would be used instead of a strap in many cases, and the cast'indicates a fixed position for the band 9 with relation to the head,

One way to use the tool will now be described. The surgeon, with the help of his X-rays, sets the palate bone. This is commonly done with the help ofa Wire with ends such as l and 2. The bone has the wire passing through it and is manipulated by handling the ends of the wire. In the case supposed, the front part of the palate bone is to be positioned to again fit the rear part. When the surgeon has the bone parts in position, brought together by his finger and instrument manipulation, the problem is to anchor the parts in position and hold them right for healing. It is desirable to provide for a traction hold-that is enough elastic pressure to keep the bones together for the best healing condition.- The main purpose of my structure is to provide an improved tool to satisfy this problem of anchoring the bone parts for healing-and under many different conditions. The wire ends I and 2 are anchored to wire parts 3 and 4 of the improved tool, as indicated in Figs. 1 and 2. Y

The tool has the following convenience in use, the description to be taken by way of example: The band 9 is anchored on the head. The wire parts 3 and 4 are positioned loosely in their adjustable mountings. -The looseness is preferably enough for a universal movement of either wire end portion in its mounting. Blocks l3 can slide up or down on legs 5 and l. The frame of these legs can pivot sidewise in slot 8. Either wire end can slide up or down in slots l5 of blocks I3. The wire 3-4 is preferably made slightly resilient. It has notches at H! and 20, in which wire ends I and 2 may be hooked. The surgeon knows in advance the approximate position in which he So he mounts the tool in place with the wire parts 3 and 4 held, but loosely held, in the approximate position he forsees. Then he manipulates wire I and wire 2, already fastened to wires 3 and 4.

, The looseness of the latter wires in their mountings permits them to follow the surgeons movement of wires 1 and 2, or the ires and 2 may be manipulated by the surgeon's moving wires 3 and 4. They are mounted loosely enough to follow his handling in the final stage of the bone setting. And when the bone parts are set to the right position by hand movements, the surgeon tightens the anchorage mountings for wires 3 and 4,

To make the final anchorage he tightens hand screws I6, one by one, and the hand nuts H. The former hold wire parts 3 and 4 to whatever tipped or horizontal position they have been moved. The latter, nuts 11, hold the legs clamped to whatever angular position they have moved with relation to slot 8. And the two mountings of course are clamped to the spaced relation to which they have been moved. In the surgeons final check-up for the desired positions and the amount of traction to be given wire parts I and 2, it is clear that the tool facilitates precise and final adjustments. Consider Figs. 1 and 2 and assume that everything there indicates a substantially correct position for the period of the healing. If the surgeon has a desire for just a little change here and there, he can make the tool respond to exactly what he wants and with great convenience. A little more or less traction on wire part I or 2, or both, is very easy to apply. A little change to any angle for the pull on wire parts I or 2 or both is easy to get. These manipulations of the tool are by way of example. Under the conditions of the surgeons work he will utilize a great many other conveniences in the tool which cannot be elaborated here.

The improved tool has a wide application in dealing with breaks in bones in the front of the skull which are frequent in automobile accidents. It is particularly adapted to bring the face back into position when disfigured. One example of this is indicated in Fig. 7 with respect to the nose. The anchorage wire 3-4 in the case of Figs. 1 and 2 is changed according to the work. Two separate wires 2|, one for each nostril, as indicated in Fig. '7, would be useful for a broken nose. It is useful, not only in setting the bones of the nose, but also for holding the nose in place until healed. In this use, as illustrated in Fig. 7, the springiness of wire parts like 2| is helpful. The wire parts mounted in the adjustable tool anchorage can apply a face-lifting force to any face operation-and in a most convenient manner. The examples given will suggest the other ones to any surgeon.

From my description it will be appreciated that the loose fit in the parts of the tool assembly, with binding means to tighten them when adjusted, is contemplated in practice.

The drawing indicates this looseness in some but not all parts. Where not indicated, the dimensions are too small to do so in proportion. The description, however, will leave no doubt of the preferred way to make and use the tool.

I Having disclosed my invention, I claim:

1. A surgeons tool comprising, a main anchorage adapted to be bound in immovable position on the upper part of the head, two wire mountings each separately adjustable sidewise on the anchorage, each mounting consisting of a frame pivoted on the anchorage for angular movement, a hand-operated clamping means to hold any sidewise and angular adjustments of the frame with respect to the anchorage, posts one on each side of the pivot, a separate block for each post slidable with a loose fit thereon, an opening through each block, a resilient wire or rod means passing through the block opening, a hand-operated clamping means adapted to clamp the wire in adjusted position with respect to the block and the block with respect to its post, all constructed and arranged for the purpose described.

2. In a surgeons tool a device for mounting a wire, comprising two spaced posts rigidly connected by a, cross piece at one pair of ends, a pivot post extendin parallel to the posts from said cross piece, a supporting frame for the device, a clamping piece on said post adapted to clamp the device to the frame in adjusted position in a frame slot through which the pivot post extends, a separate block one for each of the posts having a loose sliding fit thereon, an opening through the block for passing a resilient wire loosely therethrough, and on each block a clamping means adapted, when a wire is adjusted in both blocks to correct position for anchorage, to clamp the Wire with respect to each block separately and to clamp each block with respect to its post separately from similar clamping action of the wire with respect to the other post.

3. A surgeons tool comprising a resilient wire one end of which is adapted to enter an opening in the face to engage a part back of it for a face lifting operation, and means to anchor the other end so as to establish a resilient traction on the wire tending to gently urge the face toward. lifted position, said means consisting of two spaced blocks having loose sliding engagement near the outer end of the wire, a separate post foreach block having loose sliding engagement with its block, separate clamping means to fasten the wire with respect to each block and each block with respect to its post, all in adjusted position with respect to the opposite end of the wire with resiliency between the ends for traction, said anchorage means being adapted to be fixed on a patients head anchorage at the upper part of the head.

4. A surgeons tool comprising a band to fit across the upper part of a patients head and be anchored there by a strap, plaster cast, or the like, said band having a, forwardly extending portion, two spaced U-shaped frame members slidably engaging said portion, each having a threaded pivot post extending through a slot in said band portion, each frame member having a keeper slidably mounted on its pivot post with ends loosely engaging the legs of its frame member, a hand nut threaded on the pivot post to clamp its frame members to the band in adjusted position whereby the legs of both frame members may be fixed in desired positions, and on each leg of both frame members a separate wire clamp made up of a block slidable loosely on its leg and having a hole to loosely pass a resilient rod-like wire and a threaded member engaging the block to fasten the wire at adjusted position in the block, all adapted for the purpose of anchoring the ends of one or more wires at the upper part of 'a patients head for precise positioning of the wire into any desired positions of a great number of different positions of suspension within the scope of the tool and adjacent the lower part of the head to help manage the bones of the lower part of the skull for setting and healing.

-I-IOLLAND N. STEVENSON. 

